Macular Degeneration

Age-related macular degeneration (AMD) is a retinal disease that affects the macula, the central portion of the retina that is responsible for your sharp, central vision. AMD is the leading cause of vision loss in older Americans.

From the American Academy of Ophthalmology (AAO)

AMD results from gradual deterioration of the retina. The exact cause is unknown, but the primary risk factor is older age. Other risk factors include:

  • Family history
  • Female gender
  • Caucasian or European descent
  • Smoking
  • Obesity
  • Hypertension
  • Excessive sun exposure
  • Diet low in fruits and vegetables

There are two forms of AMD: dry (non-exudative) and wet (exudative).

Dry AMD is characterized by the accumulation of small, yellow deposits (drusen) and scarring (atrophy) under the retina. It develops slowly and accounts for 90% of cases of AMD. It is called “dry” because there is no leaking or bleeding.

Wet AMD is characterized by the formation of new, abnormal blood vessels that cause leaking or bleeding under and within the retina. It can develop quickly, either from dry AMD and or from a previously-normal retina.

Drusen from dry AMD. From VRMNY
Bleeding from wet AMD. From Eye Life Vision Center

In the early stages, AMD might have no symptoms. As the disease progresses, symptoms include:

  • Distortion (warping) of straight lines
  • Blurring, darkening, or loss of central vision

AMD can be diagnosed through a dilated eye exam that shows drusen, scarring, leaking, or bleeding under or within the retina. Ocular coherence tomography (OCT) or fluorescein angiography (FA) can help detect subtle findings.

OCT showing a normal retina (above) and retina with leaking from AMD (below). From DOI 10.1093/bmb/ldu022.

Once AMD is diagnosed, your doctor might give you an Amsler Grid to monitor for changes at home. Click here to download a grid. Cover on eye and stare at the dot in the middle. If the lines appear wavy, dim, or fuzzy, you could have leaking or bleeding from wet AMD and should call your doctor immediately.

Normal Amsler Grid. From the AAO
Abnormal Amsler Grid from wet AMD. From the AAO

There is no treatment for dry AMD. However, a combination of vitamins called the AREDS2 formula may slow or prevent vision loss. Other recommended measures include avoiding tobacco, wearing sunglasses outside, and eating a balanced diet rich in fruits and leafy, green vegetables.

Wet AMD is treated with anti-VEGF injections that shrink the new, abnormal blood vessels, thereby reducing and preventing the leaking and bleeding that cause vision loss. These injections are delivered into the eye through a very slender needle during an office procedure that takes only seconds and causes minimal discomfort. Watch the video below for more information.

Macular Degeneration Doctors

Four Convenient Locations

South Broad Street

1930 S. Broad St.
Philadelphia, PA 19145

Tel: (215) 339-8100 get directions

Allegheny Ave

2610 E Allegheny Ave
Philadelphia, PA 19134

Tel: (215) 423-5154 get directions

Wills eye Hospital

840 Walnut Street
Philadelphia, PA 19107

Tel: (215) 339-8100 get directions

Wills Northeast Consultation Office

8025 Roosevelt Blvd.
Philadelphia, PA 19152

Tel: (215) 423-5154 get directions

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